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About Us
The Feingold Association of the United States, Inc., founded in 1976, isa non-profit organization whose purposes are to generate public
awareness of the potential role of foods and synthetic additives inbehavior, learning, and health problems, and to support its members in
the implementation of the Feingold Program.
Neither a diagnosis nor a prescription is required to use the FeingoldProgram as a healthy diet choice for children and adults.
The Feingold Association does not endorse, approve or assumeresponsibility for any product, brand, method or treatment. The presence
(or absence) of a product on a FeingoldFoodlist, or the discussion of amethod or treatment does not constitute approval (or disapproval). The
Foodlists are based primarily upon information supplied bymanufacturers and are not based upon independent testing.
This booklet is for educational purposes only. This information is notintended to replace competent medical diagnosis and care.
Phone: 800-321-3287
631-369-9340Fax: 631-369-2988E-Mail: [email protected]
Web Sites: www.feingold.orgwww.ADDdiet.com
www.caveman-diet.com
www.school-lunch.orgwww.diet-studies.com
The Feingold
Association of the United States554 East Main Street, Suite 301
Riverhead, NY 11901
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BEHAVIOR,LEARNING AND HEALTHThe Dietary Connection
Edited by: Shula Edelkind
Printed in Soy Ink by: Graphic Ventures, Atlanta, GA
2003, 2007 The Feingold
Association of the United States
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We thank our supporters
Susan and Marty Berkoff
Betty Ruth and Milton Hollander
Kuriansky Foundation
B. L. Manger Foundation
Alice D. McDonaldMelissa and Greg Milbank
Annette and William Millerand
the many members and friendsof the
Feingold Association
who have helped make the
printing of this book possible
a special thanks to
our Feingold staff, medical advisors
and volunteers
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Table of Contents
Symptoms That May Be Helped by the Feingold Program....................................1
The Feingold Program (description) ......................................................................2
What the Feingold Association Provides ...............................................................3
Frequently Asked Questions ..................................................................................4
Artificial Colors......................................................................................................6
Artificial Flavors ....................................................................................................6
Preservatives...........................................................................................................7
Salicylates...............................................................................................................8
Environmental Chemicals ......................................................................................8
The Wisconsin Schools: A Different Kind of School Lunch.................................9
New York City Public Schools: Four Years of Success ......................................11
ADHD ..................................................................................................................13
Asthma .................................................................................................................14
Aggression and Disruptive Behavior....................................................................15
Enuresis (Bedwetting) ..........................................................................................16
Seizures, Headaches, and Other Physical Problems ............................................16
Autism Spectrum Disorders .................................................................................17
The PST Connection ............................................................................................18
The Gluten/Casein Connection ............................................................................18
A Call for Better Research ...................................................................................19
How Many Children Improve on an Additive-Free Diet?....................................20
Relevant Research ................................................................................................21
Concerns About the Research on Coloring .............................................22 Medication for ADHD.............................................................................22 ADHD and Autism Research ..................................................................23 Bio-Markers Biochemical Differences in ADHD................................27 Allergy: Asthma, Eczema/Urticaria ........................................................28 Physical Problems: Migraine, Seizures, Earache, etc..............................30 Colorings and Flavorings .......................................................................32 The Three Preservatives ..........................................................................34 Sweeteners...............................................................................................36 PST / Sulfation (Sulphation) Pathway.....................................................38 Animal Research Additives, Behavior and Neurology ........................39 Reviews of Research ...............................................................................40 List of Citations.......................................................................................41
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Page 2
In the U.S., the FeingoldProgram materials simplify
the process of findingsuitable foods and other
products.
The Feingold Program
The Feingold Program addresses additive and salicylate sensitivity. The Feingold Association of the United
States (FAUS) provides its members with comprehensive information on brand name foods and nonfood
products that are free of the indicated additives.
Stage One:Stage One is the initial period during which the items listed below are eliminated from the diet.
Artificial (synthetic) colorsFood dye may be listed as food coloring, U.S. certified color, certified color, or color added.
It may also be listed by its FDA number (i.e., FD&C Yellow #5), by its E number in Europe (i.e., E-
102), or by its name (i.e., Tartrazine). Sometimes the words artificial color or color added actually
refer to a natural coloring such as carmine or titanium dioxide. You will not know this, however, without
a Feingold Associations Foodlist & Shopping Guide, which is available in the U.S. and Canada. In other
countries, you need to learn your E-numbers. See page 6 for more information on colorings in the U.S.
Artificial (synthetic) flavorsArtificial vanilla (vanillin) is a synthetic flavoring generally identified by name. Most of the thousands ofartificial flavors are listed only as flavoring, artificial flavoring or natural & artificial flavoring.
Three preservativesBHA (Butylated Hydroxyanisole)
BHT (Butylated Hydroxytoluene)
TBHQ (Tertiary Butylhydroquinone)
AspartameAspartame and similar sweeteners - Equal, Nutrasweet, Spoonful, Equal-Measure, Benevia, Misura,
NatraTaste, E951, Neotame, Alitame are now excluded from the Feingold Program.
Sucralose (Splenda) and other synthetic sweeteners are not officially excluded, but products containing
them are not added to the Foodlist & Shopping Guide. Products containing alcohol sugars (names end in
-ol) are allowed, but marked with a (CS) since they are related to corn syrup. Stevia and agave are
sweeteners made from plants, and they are allowed. See page 36 for more information.
SalicylatesThese are chemical compounds found in some foods, medicines, and personal care products. See page 8
for more information.
Stage Two:
After observing a favorable response to Stage One, salicylates may be reintroduced and tested for toleranceone at a time. While some people find they need to remain on Stage One, others are able to tolerate some
salicylate-containing items occasionally, and still others can eat them freely. The artificial colors, flavors,
preservatives, and sweeteners listed above are not reintroduced.
Some chemical additives are not routinely eliminated, but products containing them are marked in the Foodlist
& Shopping Guide, so that they can be avoided at the start of the diet or later if necessary. They are: Calcium
Propionate (CP), Corn Syrup (CS), Sulfite (SF), Sodium Benzoate (SB), Monosodium Glutamate (MSG/HVP),
Nitrites/Nitrates (N), and Natural Smoke Flavor (SM).
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Page 3
What the Feingold Association Provides
New Member Package: Getting Started a national food list immediately available on line to new members The Feingold Program book indispensable for beginners
o Getting Started Sectiono Handbook Sectiono Special Needs Section introduction to dealing with SAS, Gluten, Casein, Benzoates, Sulfuro Recipes & Menu Plan Sectiono Resource Section
Information regarding other services and places to get help Dear Grandma letter to help explain to relatives and friends what you are doing
o Appendix Diet Diary Form (to photocopy) to help pinpoint reaction triggers Shopping List (to photocopy)
Foodlist & Shopping Guide 150+ page book for your region of U.S. (Canadian book is smaller) Pure Facts Newsletter 10 issues a year with Foodlistupdates and other information Fast Food Guide acceptable foods in fast food restaurants Supplements Guide to help you find supplements that meet Feingold guidelines Mail Order Guide for specialty items and hard-to-find products
Member Services: Telephone help-line E-Mail help-line Monthly e-newsletter and product alerts by e-mail as needed On-line support for subscribers to Pure Facts message board, recipes board, chat room, product alerts
list, product submission and reaction report forms
Also Available: Book: Why Cant My Child Behave? (fourth ed., 2006) by Jane Hersey; editor ofPure Facts. Based onthe experience of thousands of families for several decades,this book provides practical answers. Nearly
400 pages long, it is a valuable companion to the Program materials.
Information Packets for teachers and physicians School Year Calendar Reprints ofPure Facts articles from previous years Audio CD: What are all those funny things in food? . . . and should I eat them? Book: Behavior, Learning & Health (this book) commonly called The Bluebook Book:Healthier Food for Busy People: 20 little rules to help you navigate the supermarket
An entertaining introduction to better nutrition; 38 pages
How to Order Feingold Program Materials: The Program materials are provided to those who join the Feingold Association. Join on the website
feingold.org (also called ADDdiet.com)or call 1-800-321-3287 (in the United States). In Canada, call 1-
631-369-9340.
People outside the U.S. may become an associate member (free) through the website. The books and audio CD are also available on the website or by calling the numbers above. Financial aid is available when required, subject to available funds. Contact the Membership Office at
the number above if you need a reduced membership fee.
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Page 4
Frequently Asked Questions1. Who was Dr. Feingold?
Ben F. Feingold, M.D. was both a pediatrician and
allergist. He was Chief of Pediatrics at Cedars ofLebanon Hospital in Los Angeles, CA, until 1951,
when he became Chief of Allergy at Kaiser-
Permanente Medical Center in San Francisco. He
was considered a pioneer in the fields of allergy
and immunology. He continued his work with
children and adults with hyperactivity and allergy
long after his retirement, until his death at the age
of 82, in 1982.
2. What is the Feingold Association?
Founded in 1976, the Feingold Association is a
501(C)3 non-profit organization made up of
parents, professionals and volunteers. It is
dedicated to helping children and adults apply the
scientifically proven dietary techniques of the
Feingold Program for better behavior, learning
and health.
3. What is the Feingold Program?
This dietary program was developed at the
Kaiser-Permanente Medical Center in San
Francisco. Called the K-P Diet, it was an
outgrowth of the earlier diet for urticaria (hives)developed by Dr. Stephen D. Lockey, Sr. of the
Mayo Clinic. The media renamed it the Feingold
Diet. It is a simple approach that eliminates
artificial food colors, artificial flavors, three
preservatives, and certain salicylates as
individually necessary.
4. How can the Feingold Program
help me?
This is a good place to start. It can help you
determine if certain foods or food additives
contribute to symptoms. If they do, then the diet
itself is also the treatment, adjusted to your
individual needs. It can be part of a multi-modal
treatment protocol, and is compatible with any
other form of treatment.
5. How soon can I expect to see
results?
It varies with the individual. If the FeingoldProgram is followed carefully, you should know
within one to six weeks if food additives or
salicylates are responsible for the symptoms. As a
rule, young children respond the most quickly,
sometimes within a few days. If ADHD
medication is being used, a response may take
longer. If other sensitivities or allergies are
involved, they must also be addressed. The
Foodlist can also be used with a gluten-
free/casein-free diet, or with any allergy diet.
6. Is it hard?Changing your eating behavior is never easy, but
soon becomes a way of life. Many well-known
products are free of problem additives, and you
will be able to enjoy most of your favorite foods
just by changing some of the brands. Avoiding
salicylates is a little harder, but it is an important
part of the Program. This is also the only way
available to find out whether salicylate-sensitivity
is a problem.
7. Why can't I just read labels?Regulations governing the labeling requirements
of both food and non-food items are inconsistent;
therefore labels
frequently have in-
formation that is
incomplete or mis-
leading.
Most people think
that manufacturers
list all the ingred-
ients in a product,but it is not true.
They do not have
to list what has
already been added to the ingredients by others,
and some products are not required to list
ingredients at all. Ingredients such as flavoring
do not indicate whether they are natural or
artificial, or whether they may contain salicylate.
Clay Bennett, St. Petersburg TimesReprinted with permission
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Page 5
________________
1. Aoshima 1997, Bamforth 19932. Kroes 2000, 2002, 2004, 2005
8. How do I know which foods are
O.K. to use?
As a member of the Feingold Association of the
United States (FAUS), you will receive a book
listing the thousands of acceptable brand-name
products available in your region of the country.
FAUS began doing this work in 1976, producing
a one-page Foodlist & Shopping Guide. Today,
this unique book is over 150 pages long (the
Canadian Foodlist book is about 60 pages) and is
organized by category. You can easily take it to
the supermarket. It is reprinted frequently and
updated through the Pure Facts newsletter and e-
mail alerts. For an item to be added to this list, the
manufacturer must fill out and sign a detailed
inquiry form verifying that the product is free of
all the undesired additives including additives
in the ingredients they buy from others.
9. Will I have to cook from scratch?
Not unless you want to. The Foodlist & Shopping
Guide includes a wide selection of prepared foods
available in your supermarket. Our product
inquiry is ongoing, so new products become
available continuously. Moreover, due to
consumer demand, manufacturers are responding
by providing more products that meet our
ingredient guidelines. At the supermarket, you
simply choose products from the thousands of
acceptable items in your Foodlist, includingsnacks, cakes, ice cream, candy, and prepared
foods. Once you are home from the supermarket,
you prepare food as you normally would.
10. But what about sugar?
Many people think that sugar causes behavior
problems. If you suspect such a problem, its
more likely that the additives are to blame.
However, some people are sensitive to corn syrup
(or the chemical residues in it), some are sensitive
to beet sugar, and a few are unable to tolerate canesugar.
While items containing corn syrup are marked
with a (CS) in the Foodlist, sugar is not routinely
eliminated on the Feingold Program.
11. Are all additives bad?
There are well over 12,000 food additives in our
food supply today, nearly 2/3 of them flavorings,
but few have been tested for their effect on the
nervous system or the immune system.
Furthermore, many of those tested and found to
have unfavorable effects are still in use.1
It is, therefore, not surprising that scientists
working with the food industry2have convinced
the FDA to use the De Minimis principle (a little
bit cant hurt) so that new flavoring chemicals do
not need to be tested for side effects before being
accepted for use.
As for fragrances the FDA does not supervise or
mandate research on them or control their
labeling; they say it is because they do not have
any budget for that. (See more on page 8.)
The additives we eliminate appear to be the worst
offenders for the majority of children and adults
with ADHD and related problems. If improvement
is erratic or less than desired, our materials help
you consider other additives, such as corn syrup,
monosodium glutamate, sodium benzoate, sulfites,
etc.
12.Will I have to take my child off
behavior modifying medication?
You can begin the diet while your child is still onbehavior modifying medication, though it may
take longer for the child to respond. Members
frequently report that after using diet and
medication together for a while, their doctor is
able to reduce or discontinue the medication.
Other members report that, for their child,
medication appears to be more effective when
used with diet. For best results, we recommend
making the effort to acquire all needed medication
in a color-free form. If needed, we can help you
find a compounding pharmacist who may be able
to make the medication you need.
When removing a child from behavior modifying
medication, the childs symptoms may initially
become worse. This is a medication rebound
effect, and can last several days to several weeks.
Do not stop your childs medication without
medical guidance.
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Page 6
_________________1. Food & Drugs, Title 212. Lancaster, 19993. Tanaka 1993, 1996, 2001, 2005; Vorhees 19834. Rosenkranz 1990; Sweeney 1994; Tsuda 2001; Sasaki 20025. Aboel-Zahab 19976. Food & Drug Administration Report on the Certification of Color Additives.7. Kroes 2000, 2002, 20058. Bamforth 1993
Artificial Colors
Artificial color certified FD&C is permitted by the
Food & Drug Administration (FDA) to be added to
foods, drugs and cosmetics. D&C means the
certified color may be used only in drugs and
cosmetics. These colorings were originally
manufactured from coal tar, but today they are madefrom petroleum. The FDA certification rules list the
permissible amounts of contaminants and residues such
as lead, mercury, arsenic, and certain carcinogens such
as benzidine. It is interesting to note that the D&C
colors permitted only in cosmetics and in medications
(and given to sick children) are often allowed to have
twice the amount of lead contaminant as colorings
allowed in food.1
In commercially available FD&C Yellow #5 and #6,
benzidine (which causes cancer) has been found in
amounts up to 200 times the officially allowed level of
only 1 part per billion.2 FD&C colorings continue to be
listed as Generally Recognized As Safe (GRAS)
despite studies showing neurological effects,3 DNAdamage,4 and elevated cholesterol.5
In 2006, almost 19millionpounds of color additives
were certified by FDA inspectors. The FDA receives a
user fee from the manufacturer for each pound of
food dye certified. Note, that means each pound
approved, not each pound examined.6
Artificial Flavors
Used as low-cost substitutes for natural
flavorings, these chemicals are not
usually listed individually. One that
may be listed separately is vanillin
(imitation vanilla), widely used in
chocolate as well as in vanilla-flavored
items. Some people who believe they
are allergic to chocolate may actually be
reacting to this artificial flavoring. Onesource of imitation vanilla flavoring is
the waste product of paper mills;
another is petroleum. Therefore, while vanillin is
technically identical to one of the chemicals in pure
vanilla flavoring, the manufacturing methods result in
high levels of sulfites and other contaminants.
A single artificial flavoring can be a combination of
hundreds of individual chemicals, many of which are
derived from petroleum. As an example of a (short)
formula, here is a synthetic raspberry flavoring:
Vanillin, Ethylvanillin, Alphaionone, Maltol, 1-(p-hydroxy-phenyl)-3-Butanone, Dimethyl Sulphide, 2,5-
Dimethyl-N-(2-pyrazinyl) Pyrrole. Wheres the fruit?
Some artificial flavorings may not be
problematic, but since they are not
identified, the Feingold Program
eliminates all of them.
The FDA does not monitor these
flavorings nor require that they be
tested. Rather, a concept called
threshold of toxicological concernhas been implemented to set
acceptable daily intake levels for
chemicals of unknown toxicity, apparently on the theory
that a little bit cant hurt. This is called the de
minimis principle and was introduced to save the
time, cost, animal use and expertise usually needed for
extensive toxicity testing and safety evaluations.7
Even when testing is done, however, it may be ignored.
Vanillin, for example, continues to be listed as GRAS
despite its ability to inhibit the liver enzyme dopamine
sulphotransferase by 50%.
8
Other flavorings affectRNA, thyroid, and enzymes (el-Saadany 1991). Most
flavorings have never been studied for neurotoxicity.
See page 32 for more information about colorings
and flavorings.
Petroleum Lead Mercury Arsenic yuck. Whether or not you are sensitive to the additives weeliminate, you may wish to avoid them. Let us show you how to enjoy a normal American diet without them.
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Page 7
Preservatives
BHA: Butylated Hydroxyanisole BHT: Butylated Hydroxytoluene TBHQ: Tertiary Butylhydroquinone
Preservatives are used primarily to prevent fats from becoming rancid, allowing foods to have a longer
shelf-life. Most are not believed to be a health hazard, but the above three petroleum-based preservatives
have been found to trigger behavior and health problems.
Studies on these chemicals are disturbing. As early as
1974, a study by Stokes & Scudder1 reported that when
pregnant mice were fed BHA and BHT, it affected the
brain chemistry of their offspring, reducing their
cholinesterase and serotonin to half the normal levels.
They reported, The affected mice weighed less, slept
less and fought more than normal controls.
Since BHA, BHT, and TBHQ are included in so many
products containing other
additives as well, it would be
prudent to study theirinteractions with each other.
One of the few such studies
found that BHA can facilitate the activation of BHT in
the lung and increase its toxicity.2 Yet it is common to
find both of them in the same meal.
Recently, another study on additive interactions3
showed that a coloring plus an excitotoxin (MSG or
aspartame) is far more toxic to developing neurons than
either one alone. When two chemicals used together do
more damage than each alone added up, it is called
synergy. In real life, we are eating all these
chemicals together and for the most part we have noidea what they can do to us in such mixtures.
These preservatives continue to enjoy GRAS
(Generally Recognized As Safe) status despite evidence
that they are toxic to various cells and organs,4 they are
tumor promoters,5 they weaken the immune
system,6 they impact the nervous system and
behavior,7 they have a negative effect on sperm
and/or egg production,8 reproduction and develop-
ment.9
Sasasaki (2002) says that many of the 39 common
additives he studied, including BHT and BHA,
produced DNA damage at low doses close to the ADI,
(the allowable daily intake).10
In 1999, the National Institutes of Health (NIH) Eighth
Report on Carcinogens stated: There is sufficient
evidence for the carcinogenicity of butylated
hydroxyanisole (BHA) in experimental animals
administration of butylated
hydroxyanisole in the diet
induced papillomas (non-cancerous tumors) and carci-
nomas (cancers) of the fore-
stomach in mice.
In the year 2000, the NIH Ninth Report on Carcinogens
stated and the Tenth Report and the Eleventh Report
repeat that BHA is reasonably anticipated to be a
human carcinogen based on sufficient evidence of
carcinogenicity in experimental animals.11 When put
in their diet, BHA caused papillomas and carcinomas
in the forestomach of rats, mice, and hamsters. But
each year the NIH concludes, No data were available
to evaluate the carcinogenicity of butylatedhydroxyanisole in humans.
These preservatives are not always listed on product
labels. If the product contains oil or other secondary
ingredients, preservatives in those ingredients may not
be listed. They can be avoided, however, by using the
Feingold Associations Foodlist & Shopping Guide.
See page 34 for more about preservatives.
__________________
1. Stokes 19742. Thompson 1988, 19893. Lau 20064. Zoccarato 1987; Thompson 1988; Kahl 1983, 1993; Siman 1996; Gudz 1997; Stolze 1999; Safer 1999; Yu 2000; Groten 20005. Kahl 1984; Parke 1992; Kahl 1993; Bauer 2001; Sasaki 20026. Tryphonas 19997. Stokes 1974;Tanaka 19938. Takami 19999. Meyer 1980; Vorhees 1981; McFarlane 1997
10. Sasaki 200211. NIH11th Report on Carcinogens, http://ntp.niehs.nih.gov/index.cfm?objectid=32BA9724-F1F6-975E-7FCE50709CB4C932
Most additives have never beenstudied in combination with each
other or with environmental toxins,medications, or vaccines.
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Page 8
COOHOH
Salicylates
Salicylates [Sa-Lis-uh-Lates] comprise a group of compounds made by plants as protection
against insects and disease. Salicylates are chemically related to aspirin (acetylsalicylic
acid). There are several types, such as sodium salicylate, methyl salicylate, ethyl salicylate,
aluminum acetyl salicylate, ammonium salicylate, etc. The salicylates to be eliminated can
be found in some fruits and a few vegetables, and are used for flavor, aroma, or
preservatives in some foods, medications, cosmetics, and other non-food items. Anyoneallergic to aspirin may feel better when also eliminating salicylate-containing foods and products.
Stage One of the Feingold Program eliminates those salicylates identified as the most
troublesome. After a favorable response is seen, salicylate-containing products may
be carefully reintroduced, one at a time, to determine if there is a problem with any or
all of them.
Feingold Association members report wide variation in salicylate sensitivity, as well
as a cumulative effect and a more dramatic reaction when combined with synthetic additives. Some can eat
salicylates freely, while others can occasionally tolerate small amounts of a favorite salicylate food if they are
otherwise stable on Stage One of the Program. For those who are more sensitive than usual, a comprehensive set
of tables of known salicylate food sources is included in Program materials, based on a 1985 study of Australian
foods.1
This study considered quantity alone, with no thought of the relative toxicity of various kinds of salicylate.More study is urgently needed, but this is the best information that is currently available.
Environmental Chemicals
Artificially colored, flavored, scented, or preserved non-food items can also cause a reaction when inhaled or
absorbed through the skin. The Feingold Program will help you find household and personal care items less likely
to cause symptoms. Although the Program does not address the issue of pesticides directly, some members report
symptom improvement when pesticides in food and the environment are avoided.
PesticidesThe National Academy of Science reports neurotoxic
and behavioral effects may result from low-levelchronic exposure to some organophosphate and
carbamate pesticides. As long ago as April 1991, the
United States government report,Neurotoxicity:
Identifying and Controlling Poisons for the
Nervous System stated that everyone is at risk
of being harmed by these chemicals, but the
highest risk groups are fetuses, children, and
the elderly.
Pesticides used outside the home are easily tracked
inside and are readily inhaled and absorbed through the
skin. Children are at high risk of exposure since they
are more likely to crawl on the floor and play in the
grass and on the school playground.
Nevertheless, a main route of chronic exposure is
through the diet, and eating organic foods as often as
possible makes a measurable difference.2
PerfumesToday, fragrances are made primarily from petroleum,
and can be just as harmful as petroleum-based foodadditives. When inhaled, they go directly to the brain,
where they can trigger an immediate reaction.
Fragrances applied to the skin are also
absorbed systemically.
Various chemicals commonly used in
perfumes, cleaning supplies and even
childrens toys have been shown to cause
adverse effects in animals, including: inhibition of
motor activity, respiratory tract irritation, narcotic
effects when inhaled, hyperactivity, irritability, liver
damage, spasms and death; and, in humans: markedeye, nose, or throat irritation, numbness of fingers and
arms.3 Fragrances are not under FDA regulation
and are not required to be tested for safety. If nottested by the manufacturer, there is supposed to be a
note put on the label to that effect. This requirement
also is not monitored by anyone.4
___________________1. Swain 1985 3. Spencer 1984
2. Lu 2006 4. FDA information via phone calls by this author in 2003, and verified in 2004 and 2007.
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Page 9
A different kind of school lunch
Students in one midwestern community are enjoying fresh,
delicious food plus a big change in their learning environment.
Walk down the hallways of the Appleton, Wisconsin, Central Alternative High School and you will seestudents focused on their education, interacting successfully with each other and with their teachers. Notice the
calmness and purposefulness that sets these teens apart from others. You will notice that the hallways aredifferent in another respect. They aren't lined with soft drink and junk food machines. Then check out thecafeteria. Burgers, fries and burritos have been replaced by salads, meats prepared with old fashioned recipes,and whole grain breads. Fresh fruits and vegetables are offered, and the students drink water.
Grades are up, truancy is no longer a problem, arguments are rare, and teachers are able
to spend their time teaching. What's going on in Appleton, Wisconsin?
In 1997 Natural Ovens of Manitowoc, WI, initiated afive-year project to bring healthy food into areaschools. The goal was to show that fresh, nutritiousfood can make a real difference in the student'sbehavior, learning and health.
Just prior to the beginning of the program, GregBretthauer had been offered the job of dean ofstudents at the school. What he saw were teens whowere "rude, obnoxious, and ill mannered." Because ofproblems with discipline and weapons violations, a
police officer had to be on staff. Appleton was aschool for troubled teens that other schools had givenup on, and it was a school out of control.
The story of the Appleton projecthas been documented on a DVDand videotape called Impact ofFresh, Healthy Food on Learning
and Behavior 2004. It is also part of their Roadmapto Healthy Foods in School, and both are availablefrom Natural Press, at 1-877-628-8398 orwww.naturalpress.info.
Principal LuAnn Coenen is amazed at the change shehas seen in her school. Each year Wisconsinprincipals are required to file a report on the numberof students who have dropped out, been expelled,found using drugs, carrying weapons, or who havecommitted suicide. Since the start of the program,she reported, the number in every category has
been "zero."
Mary Bruyette, a teacher at the high school, reportsthat the students are now calm and well behaved. "Idon't have to deal with the daily discipline issues; that
just isn't an issue here." Their biggest problems noware parking and tardiness. I don't have thedisruptions in class or the difficulties with studentbehavior that I experienced before we started thefood program," she said.
Students who previously had been headed for troublehave turned their lives around, according to Dr.
Thomas Scullen, Superintendent of the AppletonArea School District. He told the interviewer, "Wehave kids who have had a lot of problems and got
through the whole lastyear without anexpulsion. Drop-outsdropped to non-existent.Kids came to school.
They have learned that with healthier foods it's goingto make them a better person. It keeps them morefocused and makes them happier." Dr. Scullen hadexpected that the healthy diet would improvebehavior, but he was pleasantly surprised that it has
had such an impact on academic performance.
Mary Bruyette says she can demand more,academically, from the students than she previouslycould. Now she can use all of her class period forinstruction. The high school's counselor, DebLarson, says, "I don't have the angry outbursts, soinstead we get to deal with the real issues that areunderlying and causing some of the problems in thekids lives."
Today Greg is dean of students in anatmosphere vastly different from what
he saw in 1997.
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"I've taught here almost 30years. I see the kids this yearas calmer, easier to talk to.They just seem more rational. Ihad thought about retiring thisyear and basically I've decidedto teach another year -- I'mhaving too much fun!"
- Dennis Abrahm,
Middle School Science Teacher
"One child arrestedwould cost theschools more."
- Dr. Barbara Reed Stitt,
Natural Ovens President
"We've got to stop usingour most preciouscommodity our kids to make extra money."
- LuAnn Coenen , Principal
Typically, while school dietitians want children to eathealthier food, they are convinced such efforts will befutile, and that if students cannot get their fast food inthe cafeteria they will buy it off campus. This doesnot appear to be a problem in Appleton, where thefood is not only natural, it is prepared with care.Natural Ovens made sure of this by supplying theirown cooks to the school.
Like children on the Feingold Program, once theseteens have made the connection between food,behavior and learning, they tend to prefer to enjoy thebenefits. One student said, "I really like the food. Ittastes good, it's hot, it's fresh." One girl commented,"Now that I concentrate, I think it is easier to getalong with people." Another student said, "If you'regoing for a big test, you want to eat great."
The on-campus policeman, Dan Tauber, is able to bea role model now, instead of a disciplinarian.Students are interested in how he eats to keep in such
good physical shape, and havenoticed their athletic abilities havea lot to do with their diet.
"Returning students are now theadvocates for the program. Thekids encourage each other,"according to Mary Bruyette."They set the example for the newkids. It works great."
Many of the changes are beingphased in to Appleton's middle and elementaryschools. Candy machines are gone and pop machinesare being replaced with juice machines or watercoolers. There is a district-wide commitment tohealthier eating and lifestyle in general.
Even in schools where more modest changes havebeen made, there are some real differences. Gary VanLankvelt, principal of the Einstein Middle School,has seen "more calmness and less bouncy activity.Students seem to be more alert and focused."
Madison Middle
School's principal,Fred Ginnochio,says the students arebuying the healthiera la carte items and
more are using the salad bar. He has found when thekids are in the halls "we have not had one incident allyear that I have had to get involved in with shoving, afight, aggressive behavior."
Dr. Scullen sees an eventual switchover in all ofAppleton's schools. "It can take several years to makethe transition. The program will sell itself on its ownmerits, given the time. I think instead of looking atthe food program as a "break-even" we have to take alook at what do we have to put in to make it reallygood for the kids."
What about increased cost?
Natural Ovens under-wrote the cost for their 5year study that willeventually impact 200Wisconsin schools. Theprice to turn the problemaround was $20,000 a year. Natural Ovens President,Dr. Barbara Reed Stitt, noted that "one child arrestedwould cost the schools more."
Dr. Scullen believes, "If it results in a happier kid,improved learning, and ultimatelya better community, then it's a costwe cannot avoid. It's something wemust do." Says Dan Tauber, "Let'sinvest in the kids now, financially,with food versus invest in themlater, financially, with 'how do wecorrect the problems we havebecause they are not eatinghealthy?'"
"Nutrition for students should be
part of the general operating budget," according toMary Bruyette. "We're concerned about everythingelse. We're concerned about new band uniforms.We're concerned about the football team. We'reconcerned about text books. Why not be concernedabout nutrition? That seems to me the basis in manycases for creating a positive learning environment."
LuAnn Coenen says, "I can't buy the argument thatit's too costly for schools to provide good nutritionfor their students. I found that one cost will reduceanother. I don't have the vandalism. I don't have thelitter. I don't have the need for high security."
www.school-lunch.org
Lets Do Lunch!
Improving Your Schools Food Program
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Page 11
New York City Public Schools:
Four Years of Success
In the spring of 1979, New York Citys public schools ranked in the 39th
percentile on standardized California
Achievement Test scores given nationwide. That means that 61 percent of the nations public schools scored
higher. They had been in the lower half of the country for years. However, for a few years in the 1980s, these
same 803 schools ranked in the upper half of the nations schools. They went from 11% below the nationalaverage to 5% above it. What happened?
In the fall of 1979, the citys Board of Education decided to make some changes in their lunch and breakfast
program. They ordered a reduction in sugar (and this would reduce dependence on prepackaged foods) andthey banned two artificial food colorings. In the next set of achievement tests, the schools averaged in the 47
th
percentile an increase five times larger than any other documented increase. Dr. Elizabeth Cagan, Chief
Administrator of the Office of School Foodand Nutrition of the New York City Board of
Education, and the researcher Dr. StephenSchoenthaler, studied the changes occurring
during these years.
As they implemented changes bringing the
school lunch and breakfast programs in linewith stage two of the Feingold Diet
eliminating artificial flavoring and coloring, as
well as the BHA, and BHT preservatives school scores rose to the 55
thpercentile. This
was a total rise of almost 16%, in a cohort of
over a million children. Moreover, when thechanges were analyzed, a dramatic difference
was found in the ratio of change to amount of
food eaten at school. Before these changes,
the more school meals the children ate, the
worse their scores. After the changes, thisreversed: the more school meals the children
ate, the better they did academically.
And that is not all when Dr. Schoenthaler
looked at which children had made such
dramatic changes that the entire school system improved, he found that it was not uniform. Not all children
made a 16% improvement. Rather, the lowest achievers improved the most. In 1979, before implementing the
dietary changes, 12.4% of the one million students in New York City schools were performing two or more
grades below the proper level. These were the learning disabled and repeat failure children. By the end of
1983, only 4.9% of children were in that category. In other words, 7.5% of a million children 75,000
children were no longer learning disabled low-achievers, but had become able to perform at the level
normal for their age. These were the children that no other efforts had helped. No other hypothesis fits: all
changes were related to the dietary changes.
What about the placebo effect could that have explained it?
Dr. Schoenthaler analyzed this possibility, in detail, but came to the conclusion that it was not possible. A
placebo effect would take place immediately and wear off. This did not happen. A placebo effect cannot
explain the reversal in the correlation of childrens scores with amount of food eaten at school. Several other
National Rankings of 803 New York CityPublic Schools Before and After Diet Changes
Percentile Rankings based on CAT Scores
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No other school district could be
located which reported such a largegain above the rest of the nation soquickly in a large population.
- Dr. S. Schoenthaler
possible explanations were evaluated and rejected as not possible because they, too, simply do not fit the facts.
The dietary change explanation, on the other hand, fits every fact observed.
A close look at the graph of student scores reveals two other interesting facts: Looking at the highest black
bar, one could wonder if something had happened that year, too. Indeed it had the school had attempted to
reduce fat in the school food. Again, this would decrease their dependence on prepackaged foods (usually
heavily laced with additives, as well as fat), and the effort brought
a modest rise in scores. The next year that effort was abandoned
and the scores again dropped. What about 1981-82? Why doesthe level remain stuck at the 51%? That year, no further dietary
changes had been introduced. The food available to the children
remained the same, and their academic results also remained the
same. The following year, when the food was improved by elimination of the petroleum-based preservatives
BHA and BHT, average scores rose again -- to well above the national average.
See more about how other schools are helping their students by improving their lunch program and how you
can help your childs school do the same at the website www.school-lunch.org
See more about recipes recommended for U.S. schools at
teamnutrition.usda.gov/Resources/usda_recipes.html
See the American Academy of Pediatrics Policy Statement on Soft Drinks in Schools at
portal.nysed.gov/portal/page/pref/CNKC/IntDocs/152.pdf
____________________________
1. Schoenthaler, SJ, Doraz WE, Wakefield JA. 1986 The Impact of a Low Food Additive and Sucrose Diet on AcademicPerformance in 803 New York City Public Schools, International Journal of Biosocial Research, Vol. 8(2): 185-195
2. Schoenthaler, SJ, Doraz WE, Wakefield JA. 1986a The Testing of Various Hypotheses as Explanations for the Gains inNational Standardized Academic Test Scores in the 1978-1983 New York City Nutrition Policy Modification Project, InternationalJournal of Biosocial Research, Vol. 8(2): 196-203
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___________________
1. www.diet-studies.com/research.html2. Brenner 1979; Alberti 1999; Carrie 2002; Gomez 2006;
Hamazak 2002; McFadden 1996; Oades 19983. Ward 1990, 19974. Litonjua 2006, Devereux 2006b5. McCann 2007
ADHD
According to the Diagnostic and Statistical Manual of Mental Disorders - Fourth Edition (DSM-IV),
Attention Deficit Hyperactivity Disorder (ADHD) or one of its subtypes can be diagnosed if the child
shows certain characteristics for a period of six months or more, with at least some of the symptoms
beginning before age 7. The symptoms are subjective, generally described by a parent, and require:
1) Six or more symptoms of lack of attention, as paraphrased below: Fails to pay attention, makes mistakes
Difficulty staying on tasks
Does not seem to listen
Fails to finish things
Trouble organizing things
Does not like homework or schoolwork
Loses things
Easily distracted
Forgetful
- OR -
2) Six or more symptoms of hyperactivity-impulsivity, as paraphrased below: Fidgets
Leaves seat in class
Runs around, is restless
Difficulty playing quietly
Acts like driven by a motor
Talks too much
Blurts out answers
Cant wait his turn
Interrupts others
For people who dont fit neatly into the categories of ADHD-attentional, ADHD-hyperactive, or ADHD-
combined, there is another diagnosis called ADHD, not otherwise specified. Diagnoses such as ODD(Oppositional Defiant Disorder), Conduct Disorder and Explosive Disorder are descriptive of their major
problem symptoms; medical treatment offered is often the same as for ADHD.
Many of the symptoms listed above overlap. For example, how would you separate the symptoms losing
things, forgetful, and having trouble organizing? Are they really three separate symptoms?
While much attention is focused on the symptoms of
ADHD, many of these children are not just problems
for their parents and teachers they are physicallysick. It is generally recognized now that bedwetting
and ADHD go together, that ear infections andADHD go together, that asthma and ADHD go
together, that sleep disturbances and ADHD go
together, etc. These children have headaches, theyhave poor appetites, they cant sleep, they get ear
infections, they have rings under their eyes, their skin
seems dry, pale, or rough they often simply appearto be unwell.
There is research that links each of these symptomsto diet,
1and when the Feingold Program works for a
child like this, most or all of the symptoms seem to
improve. It has also been noted by a number of
researchers that people with ADHD may haveabnormal levels of zinc, copper, manganese, lead,
cadmium, essential fatty acids, electrolytes, sulfate
metabolism, etc.2
These things also may need to be
addressed before the child will really be well.
Zinc is interesting, in particular, because two studies
by a chemist in England3
showed that children with
ADHD lose zinc when exposed to Yellow #5 and #6,but children without ADHD do not.
Zinc deficiency symptoms include behavioral effects
as well as various physical effects. Perhaps this is
one reason for the dramatic response many of these
children make to a change in diet not just in
attention, but in a multitude of symptoms, both major
and minor.
As this book goes to print, research on several
hundred children in the UK has just been published5
showing that 20 to 62.4 mg of food dyes andpreservative pushes ordinary children about 10%
closer to an ADHD diagnosis. As some of the
researchers commented, even if additives are not theonly cause of a childs ADHD, avoiding them
certainly may help.
The Feingold Association believes that children with
learning or behavior problems deserve careful
evaluation; any underlying physical illnesses, vitamindeficiency, and allergy should all be ruled out or
addressed during diagnosis. A brief trial of theinexpensive Feingold elimination diet can rule out or
identify sensitivity to additives and/or salicylates.
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Aggression and Disruptive Behavior
We all know that violence has increased dramatically.
Efforts at gun control, more prisons and severe
punishments all have failed to reduce our standing as
the most violence-prone of all industrialized nations.1
Experts have been calling for research on the causes,and the National Research Council recommends
identifying genetic and biological factors of violence-
prone children.2 However, genetic factors do not
change in one generation, and cannot explain the whole
story. It is time to begin paying attention to research
being done in another direction. As long ago as the
1980s, studies in both schools and jails dramatically
showed that a diet that removes additives and enhances
nutrition brings significant improvement in behavior
and academic performance.
In 1985 Dr. Stephen Schoenthaler published a series of
studies on 12 juvenile correctional facilities, housing8,076 young offenders.3 Just as he showed in the school
studies (page 11), not all the
children improved, but 20% of
them made such a dramatic
recovery that the total of
deviant behaviors for all the
children fell by 47%.
At a Tidewater, VA detention facility, behavior
problems fell 48% following dietary changes: Violence
declined 33%, theft dropped 77%, etc.4
A controlled study of 1,382 youths at three Los Angeles
County probation detention centers found a 44%reduction in bad behavior,5 and a northern California
probation department facility making similar dietary
changes6 found that violence fell 25% and horseplay
declined 42%. In both these California institutions,
suicide attempts fell 44%.
Animal studies7 on the petroleum-based antioxidant
preservative BHA, BHT, and TBHQ have long shown
them to cause decreased learning and grooming, and
increased activity, developmental delays and
aggression. Other studies8 have shown these
preservatives to be carcinogenic as well.
Isnt it time to simply replace these three preservatives
with others equally available but less harmful?
Instead, in efforts to reduce transfats, we have greatly
increasedthe use of these chemicals in food oil. We
will all have to pay the piper in the form of increased
cancers, increased violence, increased school problems,and decreased academic performance.
Again, studies9 have shown that violence-prone males
have abnormal copper-to-zinc ratios, and that 75% of
young criminals have allergy and nutritional problems.
In 1997 and 1998, Bennett showed that when treated
appropriately by diet and nutritional intervention, most
young offenders improve and never re-offend. Even
earlier, a chemist in the UK had found that children
with ADHD lost zinc through their urine when exposed
to Yellow #5 and #6, resulting in a variety of
symptoms, including aggresssion and violence.10
Monkeys fed soy formula11 (which has much more
manganese than breast milk)
develop neurological and
behavior problems. Some
violent adolescents have been
found to have high levels of
manganese in their hair.
In 1989, the Kellogg Report12 said, Nutrition, lifestyle
choices and the state of our environment hold solutions
to many of the crises which beset society. They go on
to say, Many who readily accept the link between diet
and heart disease or other chronic physical conditions,find it hard to imagine that nutrition could have a direct
and determining effect on human behavior and
personality dysfunctions.
A more recent review of the literature on violence
discusses cholesterol and hormone levels, nutritional
deficits, prenatal/postnatal exposure to metals, smoking
and other toxins, iron, zinc, neurotoxins, brain injury,
and the family enviroment. 13
Organizations and families dealing with violent
children (and adults) must begin to consider the role of
foods, additives, heavy metal exposure, essential fatty
acid levels, vitamins, and other dietary factors.
We may not be able to provide every childwith two loving parents, but we really canimprove nutrition, reduce toxins, and eventest for metabolic abnormalities throughour schools and medical services.
_____________________1. N,Y.Times, Nov.13, 1992, Study Cites Role of Biological and Genetic Factors in Violence2. Ibid.3. Schoenthaler 19854. Schoenthaler 1983, 1983a5. Schoenthaler 1986, 1991; See the experience of several schools at www.school-lunch.org6. Schoenthaler 1983b7. Meyer 1980; Stokes 1974; Tanaka 1993; Zoccarato 19878. Bauer 2001, 2005; Kahl 1984, 1993; NIH 11th Report on Carcinogens 1005; Sarafian 2002; Sasaki 2002; Thompson 1988, 19899. Walsh 1997; Bennett 1997, 1998
10. Ward 1990, 199711. Cockell 2004; Golub 200512. The Kellogg Report 198913. Liu 2005
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_____________________
1. Robson 19972. Salzman 19763. Egger 19924. Egger 19895. Egger 1983, 19856. Ward 1990, 19977. Oades 19988. Megson 2000:www.diet-studies.com/megson.html
Enuresis (Bedwetting)
As if the child with learning and behavior problems doesnt have enough to deal with, bedwetting (nocturnal
enuresis) and daytime wetting (diurnal enuresis) may be another part of their daily struggle. ADHD children at
age 6 are 2.7 times more likely than controls to have nocturnal enuresis and 4.5 times more likely to have diurnal
enuresis.1 It has been known since at least 1976 that an improvement in diet can cure enuresis in many children.2
In 1992, Egger et alreported on 21 children with enuresis who had been successfully treated by diet for either
hyperactive behavior or migraines. For 12 of them, the enuresis stopped, and for another 4 it improved. Theyconfirmed this by a double blind follow-up study.3
Although the Feingold Program has never been promoted as a bedwetting cure, over the years parents have
frequently reported that one of the benefits they have seen with the Feingold Program is the disappearance of
bedwetting.
Seizures, Headaches, other Physical Problems
Other symptoms also often improve on the Feingold
Program. When implementing the diet for behavior
problems, parents are more often than not surprised
that the childs (or their own) headaches, sleepdifficulties, GI problems, skin problems, etc. are
suddently gone, as well.
There are many symptoms that travel with the
symptoms of ADHD but are often either treated as
separate illnesses or ignored
altogether. Besides the asthma and
bed-wetting already discussed, some
people suffer from chronic headaches
or migraine, frequent earaches,
stomach aches, trouble sleeping,
chronic dehydration, dry or allergic
skin conditions, seizures, etc. Not allpeople have all these symptoms, of
course, but all the people who
respond to dietary intervention fit
somewhere in the profile of symptoms
on page 1, represented here by three interlocking
circles. It is astonishing how many parents report that
their children have all the symptoms listed and yet
by simply changing their diet, all or most of their
problems improve or disappear.
In research, this has been shown repeatedly by studies
on migraine, seizures and enuresis. Egger found that
in 45 children with epilepsy as well as various physicalor behavioral problems listed in our symptoms list,
80% of them improved on his elimination diet.
However, of the 18 children with epilepsy alone and
no other symptoms, none improved.4
In other studies,5 Egger found that 93% of 88 children
with frequent migraine, and 81.6% of 76 overactive
children, recoveredon an additive-free diet. Again,
other symptoms these children had, and which alsoimproved, included abdominal pain, behavior disorder,
seizures, asthma, and eczema.
Ward,6 a British chemist, found that ADHD children
(but not normal children) lost zinc in response to
exposure to Yellow #5 and #6. They
exhibited a variety of symptoms
including asthma, speech problems,
behavioral deterioration, eczema, and
aggression. And in 1998, Oades
found that children with ADHD
drank four times as much water as
normal children, yet tended toremain dehydrated, had twice the
normal level of neuropeptide Y, and
excreted more norepinephrine and a
serotonin metabolite, but less
sodium, phosphate and calcium than normal children.7
Could these findings indicate a genetic difference?
Possibly. Or could it indicate damage to the sulfation
system by vaccination or other chemical exposure, as
suggested in a Congressional Committee hearing?8
Also possible. Or perhaps the implicated additives
are akin to drugs and what we see as symptoms are
actually side effects? Again possible. What is clearto us, at least, is that the difference in these children is
at a level basic to many bodily functions. Treating it
at the specific receptor level, as is done with stimulant
medication, may ameliorate some symptoms, but is
never a cure. A better choice, often with better results
and no side effects, is appropriate dietary change.
Certainly, diet is worth trying first and worth
continuing even if some medications must be added in
individual cases for maximum relief.
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_____________________
1. This is clearly illustrated by hunter-gatherer tribes who rarelysuffered from diabetes until they adopted the Western diet andculture which they were not genetically able to tolerate. Almostimmediately, they developed an epidemic of diabetes afflicting upto 50% of their population.
2. Pima Indians, Genetic Researchwww.diabetes.niddk.nih.gov/dm/pubs/pima/genetic/genetic.htm
3. National Vaccine Center - www.NVIC.org
Autism Spectrum DisordersAutism, High Functioning Autism,
Pervasive Developmental Delay (PDD), Aspergers Syndrome
Not so many years ago, autism was a rare disorder,
affecting 3 in 10,000 children. In 1997, the Autism
Society of America reported that autism occurred inapproximately 1 of every 500 births, the symptoms
usually becoming apparent during the first three years
of life. This was already, at that time, considered an
epidemic.
In 2006, however less than 10 years later the
Centers for Disease Control acknowledged that 1 in
150 children in the U.S. is autistic. In July, 2007,
British researchers confirmed that the rate of autism in
Great Britain has risen to 1 in 58. Autism is the fastest-
growing develop-
mental disability
today.
Much of the on-
going research is
devoted to dis-
covering a genetic
predisposition for
autism. It is worth
keeping in mind,
however, that it is
simply impossible to have an epidemic and this IS an
epidemic of a genetic disorder unless gene variations
that were harmless for centuries have now suddenly
been impacted by some change in the environment.1, 2
A growing body of evidence suggests that observable
symptoms of autism are linked to biochemical intol-
erances, allergies, or metabolic errors. It is believed
that foods and environmental factors play a major role.
One of the environmental changes causing much
controversy is the increase in vaccine exposure.
According to the National Vaccine Information Center,3
safety research on these vaccines is deficient, and the
vaccines themselves certainly contain enough chemical
toxins to pose a problem for any babies who may
(genetically) have difficulty dealing with them.
Research studies underway in England, Norway, and
the United States are investigating biochemical
processes and genetic errors in patients with autism.These include gluten and casein intolerance, phenol-
sulfotransferase (PST) deficiency, and others.
Hopefully, research will soon reveal methods to detect
those children at risk, to protect them before they
become autistic.
Many families have reported that symptoms of autism
improve by using the Feingold Program alone or in
combination with a gluten-free, casein-free (GFCF)
diet. Some Feingold members find their ADHD
children also benefit
from the GFCF Diet,
and some medicalprofessionals now
put ADHD at the
mild end of what
they are calling
Autism Spectrum
Disorders (ASD).
One very impressive
nonprofit organiza-
tion is the Autism Research Institute (ARI) headed by
the late Dr. Bernard Rimland, who first recognized
autism as a biological disorder rather than a mental
illness.
Since 1967, the ARI has collected data from more than
18,500 parents of autistic children. They ask parents to
rate the interventions they have used for their children.
More than 40 drugs have been rated, from Adderall to
Zoloft, as well as 26 supplements and 9 dietary
variations.
Overall, the supplements and diets show higher success
rates than the medications. The rate of negative
responses (getting worse), moreover, is much higher for
medications than for the other treatments.
The most successful diet is the GFCF Diet (65%),followed by the Candida Diet (54%) and the Feingold
Diet (53%); the best rated non-drug treatment is
Chelation (76%); the best rated supplements are
Vitamin B12 (63%) and Melatonin (61%); and the best
rated drugs are Diflucan (55%), Nystatin (49%),
Risperidal (54%), and Secretin IV (48%).
Web sites worth visiting:
www.autismNDI.com - Autism Network for DietaryIntervention
www.autismwebsite.com/ari -Autism Research Institute
www.autismwebsite.com/ari/treatment/form34q.htm -Parent Ratings of Biomedical Interventions
www.gfcfdiet.com - Gluten-Free, Casein-Free Diet
www.diet-studies.com/megson.html -Mary Megson, MD,at Congressional Committee, April 2000
www.nvic.org -National Vaccine Information Center
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NEURON FIRING
________________
1. Alberti 1999; Scadding 1988; Sinaiko 19962. Bamforth 1993; Harris 1996; Sinaiko 19963. Harris 19984. McFadden 19965. Blass 19966. Great Plains Lab: 1-913-341-8949, [email protected]
The PST Connection
Some people have too little of an important enzyme
called phenol sulfotransferase (PST).1 It is made in
the intestines, which need PST to metabolize (detoxify)
the phenolic compounds in many foods, including
salicylates and the high-phenolic petroleum-based
additives. However, the brain also requires PST forhousekeeping duties involving neurotransmitters
those chemicals which jump the tiny space (synapse)
between brain cells (neurons). Each time a neuron
fires and the neurotransmitter jumps that space,
PST must prepare the space to fire again. This is
measured in nanoseconds, occurs
millions of times a second all over
the brain and must be perfectly
synchronized.
If a person is marginal or low in PST, and eats lots of
high-phenolic foods and additives, there may not be
enough PST left to do the clean up work in the brain,thus preventing neurons from firing effectively.2
Moreover, it seems that salicylates (which are also
phenolic compounds) not only need PST but actually
suppress its production,3 making PST levels even
lower. This explanation is over-simplified and the
evidence is indirect, but it may help explain why the
avoidance of salicylates at the start of the Feingold
Program is important. Once suppression is stopped,
there may be some recovery, leading to the later
tolerance of salicylates usually seen. Surely, this isonly part of a larger and complex picture, but in this
area the circumstantial evidence is mounting. See more
at pages 8 and 38.
In practice, the Feingold Program guides parents in
choosing a low-phenolic diet,
taking stress off a fragile sulfation
system.4 This may be especially
important for people with autism,
who have been shown to have
extremely low PST levels. Other interventions that
may help include avoiding sources of sulfite (SO3),
while increasing sources of the sulfate (SO4) which isneeded for PST production. Some people increase
sulfate through the skin (epson salt baths) or by
drinking Evian water.
A baby nurses, and usually falls asleep when full. This
is due partly to endorphins made by the baby when
tasting milk, and partly to the milk protein itself which
enters the babys blood in a morphine-like form.
5
Thisleaky gut is normal in babies, and is one reason that
babies may develop allergies if given solid foods too
early because when other partially digested proteins
get through the gut wall and into the blood, where they
dont belong, they may be treated as invaders by the
infants developing immune system. Toward the end
of his first year, the babys intestinal wall becomes less
permeable, allowing tolerance for new foods.
However, if anything has happened to prevent this,
damaging the delicate intestinal system, the growing
child may experience symptoms of digestive distress,
allergies, or cognitive problems. It has long been
known that incompletely digested proteins can causeallergies. Less well known is that the incompletely
digested casein protein (casomorphin) and gluten
protein (gluteomorphin or gliadorphin) both act as
morphines, possibly causing symptoms of autism,
ADHD, or even schizophrenia.
Unfortunately, many children with autism crave the
casein and gluten that hurts them like little drug
addicts, they need their fix. Parents of such children
report that their childs whole diet consists of macaroni& cheese, cereal & milk, bread & butter, pizza, cheese
puffs, cheese sandwiches, puddings, etc. Moreover,
these children may have sensory problems related to
diet some tolerate only soft foods, while others cannot
stand the feel of soft foods and require crunchiness.
Removing casein and gluten quickly from such a
childs diet may be a Mission Impossible task. We
recommend a slower approach, beginning with the
much easier regular Feingold Diet which alone may
decrease some symptoms and improve appetite.
Meanwhile, several tests provided by the Great Plains
Laboratory6 can help determine whether the child
actually needs a gluten/casein free diet, whether he maybe deficient in zinc or other minerals, etc. If necessary,
casein and gluten items can be replaced very slowly, a
tablespoon per day, for example. Remember that this
is an addiction condition, and the child may have
serious withdrawal symptoms, including behavioral
deterioration, if changes are made too quickly.
The Gluten/Casein Connection
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A Call for Better Research
Scientists who study the effects of additives on behavior have traditionally studied only the handful of allowed
synthetic food colorings, ignoring the other 12,000 food additives now in use but never tested for
behavioral or neurological effects. Safety studies usually test each additive alone, although we eat lots of
them together, often combined in a single product. A landmark study (Lau 2006), recently found that two
additives commonly used together inhibited developing neurons many times more than they were expected to
do, based on the damage each caused alone. More studies on such common combinations are urgently needed.Animal studies on food dyes traditionally focus on whether they cause cancer, damage reproduction, or distort
physical development. They have only rarely concerned themselves with cognitive function in either animals
or people and when they do, they use concentrations of the dyes at levels far below the known average daily
intake. Long ago, a group of food additive and chemical companies calling themselves The Nutrition
Foundation recommended using 27 mg per day of artificial food colors in human studies on food additives
and behavior. Meanwhile, a National Academy of Sciences study on 12,000 people showed that 99% of them
ate up to an average of327.6 mg of dye per day (in 1977). With todays blue oatmeal and red applesauce, it
may be much higher.
Food ColoringAverage Mg / Day We Ate in1977 per National Academy
of Science Survey
Mg / Day the NutritionFoundation Recommends for
Research on ADHD & DietRed No. 3 24.0 1.6
Yellow No. 5 + No. 5 Lake 65.0 7.3
Green No. 3 04.3 0.1Blue No. 1 + No. 1 Lake 22.6 0.8
Yellow No. 6 + No. 6 Lake 51.0 6.1Blue No. 2 + No. 2 Lake 10.9 0.5
Red No. 40 + No. 40 Lake 127.0 10.5Orange B (not used since 1978) NOT LISTED 0.1
TOTAL 327.6 27.0
27 mg of coloring is about how much is in a single
glass of a red drink made from a powdered mix. It is
about how much is in a half-teaspoon of bright redfrosting or a half-teaspoon of green ketchup.
Although companies decline to tell us how much
coloring is actually in their products, an analyticalbalance and an artists eye brings you the following
estimates:
Red frosting = 155 mg of Red #40 per Tb
Green ketchup = 150 mg of pre-mixedYellow #5 and Blue #1 per Tb
6 oz red cherry drink from a mix = 18 mg of
Red #40
The Feingold Association would like to see research
that:
1. Studies the Feingold Program as it is reallyused in the real world with Feingold
Association Program materials;
2. Uses realistic amounts of mixed additives,for a reasonable time period, for challenges;
3. Studies prevalence and relative toxicities ofthe different natural salicylate compounds;
4. Studies the combination of various salicylatecompounds with synthetic additives;
5. Studies neurological effects of synthetic
flavorings alone and in combination withother additives and salicylates.
Look around your local supermarket at the blue sports drinks, colored ketchup, garish cereals andfruit roll-ups, and you will wonder just how much of these chemicals you really eat in a day. Even thefat-free mayonnaise and sour cream contains coloring to keep its rich white appearance. What aboutthat healthy-looking yellow bread? Is it egg yolk? Or Yellow #5? Are those really blueberries in theblueberry muffin? Or lumps of colored, flavored gel? Did the color of that strawberry popsicle comefrom a strawberry or a test tube?
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Hoffmann-LaRoche, Inc. pharmaceuticals
Fritzsche-D & O, Inc. artificial flavors Stange Company artificial colors & flavors Florasynth, Inc. artificial flavors Kohnstamm & Co. artificial colors & flavors PFW, Inc. artificial flavors Monell Chemical Senses Ctr artificial flavors
ICI Americas, Inc. dyes, pesticides, petrochemicals Ajinomoto Company, Inc. MSG
Griffith Laboratories nitrites
The Coca-Cola Company CPC North Americacorn syrup
Amstar Corporationsugar
Revere Sugar Corporationsugar
In these studies, the researchers put the children on an additive-free diet similar to the Feingold Diet. As you
can see above, they found that a high percentage of children improved. Later, each researcher gave the
children an additive or group of additives in a double-blind test. The results varied, depending upon the type
and amount of challenge material.
The amount of food dyes recommended by the Nutrition Foundation for researchersto use in their studiesper person per day ........................................................ 27 mg
Average amountof food dyes actually consumed, according tothe National Academy of Sciences in 1977 per person per day....................... 327 mg
This 327 mg does not take into account todays blue soda, colored applesauce, fluorescent cereals, striped
toothpaste, and other such questionable inventions. One must assume todays rate is higher, especially for
children, to whom many of these fun foods are marketed. No studieshave been done proving that 300 mg
or more of food coloring are neurologically safe for children.
Who was the Nutrition Foundation? It was a trade industry organization, now called the International Life
Sciences Institute (ILSI). In 1977, the Nutrition Foundation members included representatives from:
How Many Children Improved on an Additive-Free Diet?
73%
80%
93%
100%
50%
73%
81%
75%
82%
76%
0
20
40
60
80
100
Levy
1978
Egger
1983
Egger
1985
Rowe
1988
Egger
1989
Kaplan
1989
Carter
1993
Boris
1994
Rowe
1994
Pelsser
2002
Study & Year
PercentofChildrenImproving
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Relevant Research
Table of Contents:
Concerns About the Research on Coloring ................................................................................. Page 22
Medication for ADHD................................................................................................................. Page 22
ADHD and Autism Research ...................................................................................................... Page 23
Bio-Markers Biochemical Differences in ADHD .................................................................... Page 27
Allergy: Asthma, Eczema/Urticaria ........................................................................................... Page 28
Physical Problems: Migraine, Seizures, Earache, etc................................................................. Page 30
Colorings and Flavorings ........................................................................................................... Page 32
The Three Preservatives .............................................................................................................. Page 34
Sweeteners................................................................................................................................... Page 36
PST / Sulfation (Sulphation) Pathway ........................................................................................ Page 38Animal Research Additives, Behavior and Neurology ............................................................ Page 39
Reviews of Research .................................................................................................................. Page 40
List of Citations........................................................................................................................... Page 41
Studies are listed alphabetically in each section by last name of primary author.
=Double Blind Placebo Controlled Study
The Role of Diet in BehaviourBen F. Feingold, MDwritten just before his death & published posthumously in Ecology of Disease. 1982. 1(2-3) pp.153-65.
"The increase in behavioural disorders accompanied by a persistentdrop in scholastic performance coupled with the continuing rise in theprevalence of delinquency is undoubtedly one of the most important
expressions of the disruption of nature by the rising concentration ofpollutants in the ecosystem Public recognition and participation inthe problem are mandatory to correct the insidious downgrading ofthe human race, which is already evident.
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Concerns About the Research on Coloring
Double-blind challenge studies: Usually colorings alone are used as challenges, often only a smallamount of a single color. The other thousands of additives eliminated by the Feingold Program are ignored.
The increasing use of synthetic colorings without adequate testing: A recent study of children (Husain2006) revealed that the children are eating 2 to 8 times more than the acceptable daily intake (ADI) of
food coloring. The authors are concerned about the possible health effects on the children. This study tookplace in Kuwait. How much food coloring are American children eating?
Since companies refuse to reveal how much coloring is in their products, how do you know how much youare actually eating? To give you an idea, two of our students at a university in Atlanta measured the
following:
1 TB red frosting (or other opaque item) = 150 mg of Red #40 (3 TB to frost a cupcake = 450 mg) 1 TB green ketchup = 150 mg of Yellow #5 + Blue #1 mixed (2 TB for friesand a burger = 300 mg) Small cup (6 oz) red powder-mix drink (Red #40) = 18 to 20 mg
NO STUDY of 400-800 mg food dyes has ever been done on any children normal or ADHD!
Medication for ADHD
Stimulant medications work - often dramatically. Unfortunately, one of the worst side effects of these drugs
small vessel disease can only be diagnosed by viewing the heart at autopsy. People using both the Feingold
Program and stimulant medication report needing much less medication. As far as we know, no research has
yet been done to explain this.
Bailly D, 2006 Since the introduction of Selective Serotonin Reuptake Inhibitors (SSRIs, e.g. Prozac) in the
1990s, reported side effects include excitation, restlessness, disinhibition (acting out), and self-injurious thinking and behavior. Authors warn that side effects must be monitored frequently.
Brown 1989 11 black male children with ADHD were given placebo and Ritalin for two weeks each. Theyhad a significant increase in blood pressure on Ritalin, and should be monitored carefully.
Castner 2003 Primates given amphetamine develop monoamine dysregulation and hallucinations.
Symptoms include looking at and reaching for things not there, and hypervigilance.
El-Zein 2005 12 children were tested before and 3 months after starting on Ritalin. In all of them,
chromosome abnormalities were tripled. The relationship between chromosome abnormalities and
canceris well-documented.
Food & Drug Administration 2005 Manufacturers were ordered to add a "Black Box" warning to the
labeling of all antidepressant medications because they can cause suicidal thoughts and behavior.
Henderson 1995 Small lesions (damaged areas) were found in the myocardium (heart wall muscle) of a
patient treated with Ritalin. Rats and mice were injected with various doses of Ritalin, and their
hearts were examined. Heart damage was found in all cases, even with the smallest doses given for
the shortest time.
Kelly 1988 In 47 children with ADHD, doses of Ritalin were linearly related to increasing heart rate
depending upon both the initial rate and the length of time on medication.
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Markowitz 1999 Ethylphenidate was found in the blood and liver of people who died after taking Ritalin
(methylphenidate) and alcohol (ethyl alcohol). Authors do not know what this chemical does or if itis toxic. Note: Taking Ritalin to drink more alcohol without passing out is a new party activity.
Olfson 2006 In this case-matched study, antidepressant drug treatment in children under 19 was significantly
associated with suicide attempts and deaths. Antidepressants are sometimes used with ADHD
treatment.
Public Citizen 2007 In their newsletter,Best Pills Worst Pills, they report that all stimulant medications forADHD, and also Adderall, must carry Black Boxwarnings about the risk of these medications to
cause increased blood pressure, stroke, heart attack, new or worse behavior, bipolar illness, increased
aggression, psychotic or manic symptoms, as well as sudden death in patients with heart defects.
Wang 1994 Ritalin decreased blood flow in all regions of the brain in 5 healthy men, up to 30% in some
regions. The authors recommend that this effect on blood vessels be considered when prescribing.
ADHD and Autism Research
Bateman 2004
In a large group of normal toddlers, a small (20 mg) amount of coloring with benzoatepreservative caused adverse effects detectable by parents. Bateman suggests removing these additives
from the diet of all children.
Bennett 1997 A survey determined that 75% of young criminals,
but only 18% of non-offenders, are physically ill with allergy
and nutritional problems.
Bennett 1998 When treated for food intolerance, allergy, and
mineral imbalance, 9 child criminals improved physically andpsychologically. 7 of them continued the diet and continued
to improve. After 2 years, 5 of them had never re-offended.The authors recommend this approach for criminal justice,
education, and health agencies.
Boris 1994 73% of 26 children with ADHD responded well to an
elimination diet. 16 of them were given a double-blind test
with 100 mg of color and suspected foods. ALL reacted to it.Boris concludes, Dietary factorsmay play a significant role
in the etiology of themajority of children with ADHD.
Brenner 1977 Intending to prove Dr. Feingold wrong, Brenner
offered the diet to 32 families whose children had not improved on medication. On the diet, 11(34%)were markedly improved thestartling changesseen in patients who had been followed for
years with other forms of therapy suggest strongly that this improvement was genuine.
Brenner 1979 Lab tests 20 children who responded to the Feingold Diet, and 14 who did not, were testedfor zinc and copper levels in their blood. Children who responded to the diet had high copper levels in
their blood. (See the Ward studies, page 27.)
Cade 2000 High IgG antibodies to gluten were found in 87% of autistic and 86% of schizophrenic patients.IgG antibodies to casein were found in 90% of autistic and 93% of schizophrenics. A gluten-casein
free diet was accompanied by improvement in 81% of autistic children. This supports the proposal
that both disorders are due to absorption of morphine-like chemicals formed in the intestine from
digestion of gluten and casein.
Risk-Benefit AnalysisBy Philip Handler, Pres.*
National Academy of Sciences
A sensible guide would surelybe to reduce exposure tohazard whenever possible, toaccept substantial hazard onlyfor great benefit, minor hazardfor modest benefit, and nohazard at all when the benefitseems relatively trivial.
The manufacturer benefits fromthe use of inexpensive syntheticcoloring; the consumer bears allthe risk, with no benefit whatso-ever.*2 terms, 1969-81. He also receivedthe National Medal o Science.
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Hamazak 2002 DHA (in fish oil) controls aggression in young people under stress, and this study was
designed to see if it is useful for elderly people. The ordinary food intake of 150 mg per day was notenough, but getting an extra 1.5 g of DHA a day significantly decreased aggressiveness in older
university employees, while the placebo did not. Note: Fish oil is not part of the basic Feingold
Program, but much research has shown it to be a helpful addition to everyones diet. 1.5 g of DHA is
1500 mg 10 to 15 capsules of fish oil, depending on the brand.
Harley 1978 10 hyperactive preschool children were tested with two diets, not
knowing which was the Feingold Diet. 100% of them improved on theFeingold Diet. Harley admits he was not in a position to refute his
[Feingolds] claims regarding the possible causative effect played by
artificial food colors in preschool children.
Harley 1978 36 school-age boys were tested with 2 diets after
stopping their medication. Only 22 of them were